{"edition":"usa","organization":"US Alcohol Policy Alliance","organizationId":"org:us-alcohol-policy-alliance","boundaryVersion":"USA-50-states-DC-v1","updated":"2026-09-13","model":{"version":"usa-usapa-alpha-1","costScope":"All recipient costs at a judged $350,000 annual current scale for five years, informed by the published $200,000–350,000 operating plan. Historical IRS expenses are separately disclosed. Tax-only health quantified; not a restricted-program price or full social cost.","geographicAttribution":"The modeled policy population N consists only of residents of 50 states plus DC, so g=1 by construction. N is a subjective successful-policy scale, not measured reach or a headquarters/population-share allocation. Foreign attendees and territorial effects are excluded from credited health while all recipient costs remain.","formula":"A=sum(t=1..T)1/(1.03^(L+t)); annual avoided disease deaths=N*d/100000*x*e*k; H=annual avoided deaths*q*A. Q_all=b*(p*a*H-h); Q_USA=g*Q_all. Cost=C*Y; price=10*Cost/Q_USA if positive. Central A=7.8063439787, annual deaths=10.275, H=802.1018438079 before policy/funding attribution. Small support normalization G multiplies both by G/(C*Y), not a scalable guarantee.","counterfactual":"State advocates, legislators, researchers and fiscal pressures operate without USAPA. Only an incremental coalition-enabled policy chance is counted, with small USAPA contribution and donor/reserve substitution. No nationwide federal tax victory, historic state victory, concurrent treatment revenue or injury effect is credited. Ten years is a judged differential duration, which falls if baseline adoption catches up.","attribution":"p=.20 is incremental coalition policy probability, a=.05 is USAPA's conditional share, and b=.50 is donor additionality. Effective pre-funding policy contribution is 1% of one five-million-resident package. These are explicit opinions supported by network activity, not measured causal rates. Do not sum overlapping state/charity credit.","uncertainty":"Exploratory expected-value best estimate with very broad scenarios. It can fail at policy influence, price pass-through, heavy-drinker response, survival or funding additionality. Unknown other portfolio effects mean this is not a proven lower bound. Central number is not donor-ready endorsement.","nativeOutcomes":"Conferences, technical assistance, newsletters and policy discussion are services. A funded-to-policy-to-retail-price-to-disease-mortality bridge is required before QALYs. The modeled mortality subset excludes accidents, homicides and most partly attributable disease; no conversion from awareness or tax dollars to health.","inputs":[{"name":"C","value":350000,"unit":"USD per recipient year","basis":"judgment","rationale":"Upper end of publicly described $200,000–350,000 annual operating plan, not an observed 2026 expense. Includes new executive leadership, communications, convening and overhead; current accounts missing. Test $250,000–700,000.","sourceIds":["usapa-budget-plan","usapa-ceo"]},{"name":"Y","value":5,"unit":"recipient support years","basis":"judgment","rationale":"Entire five-year recipient operating cohort, not only a tax campaign budget.","sourceIds":[]},{"name":"N","value":5000000,"unit":"resident population covered by a successful policy package","basis":"judgment","rationale":"One medium-state-equivalent package across the network, not actual wins or all 15 states. Public plan described 15 state alliances; national/state advocacy could support this scale, but the next target docket is unverified.","sourceIds":["usapa-budget-plan","usapa-state-training","usapa-podcast"]},{"name":"d","value":13.7,"unit":"alcohol-induced deaths per 100,000 residents annually","basis":"observed","rationale":"CDC2024 crude national alcohol-induced rate, excluding accidents and homicides. Applying it to a future policy population is a transfer judgment, not observed state mortality. No 178,000 broader-attributable-death numerator.","sourceIds":["usapa-cdc"]},{"name":"x","value":0.05,"unit":"proportional alcohol retail-price increase","basis":"judgment","rationale":"A reasonably material all-beverage policy package. Five percent RETAIL PRICE, not five percent increase in excise-tax rate; tax design and pass-through required to attain it remain unknown.","sourceIds":[]},{"name":"e","value":0.4,"unit":"absolute disease-mortality elasticity to retail price","basis":"judgment","rationale":"A 5% retail-price rise is assumed to reduce targeted alcohol-induced mortality 2% before leakage. Intentionally modest relative to some historical disease studies, allowing weak heavy-drinker response, confounding and modern transport. Not fitted from the NY study or the charity's website.","sourceIds":["usapa-ny-study","usapa-maryland-study","usapa-illinois-reanalysis"]},{"name":"k","value":0.75,"unit":"retained policy effect","basis":"judgment","rationale":"Post-price avoidance, cross-border/beverage substitution and subsequent real-value erosion only. Initial pass-through is already included in the actual retail-price increase x and is not discounted again.","sourceIds":["usapa-illinois-reanalysis","usapa-maryland-study"]},{"name":"q","value":10,"unit":"discounted QALYs per averted alcohol-induced death","basis":"judgment","rationale":"Approximately 20 additional life-years at .65 quality discounted 3% gives about 9.7 QALYs, rounded to 10; chronic comorbidity and mortality displacement could make it much lower. Test 3–15.","sourceIds":[]},{"name":"L","value":3,"unit":"years before first benefit window","basis":"judgment","rationale":"Legislation, implementation and disease-response lag; first counted outcome year is year4.","sourceIds":[]},{"name":"T","value":10,"unit":"years of retained incremental effect","basis":"judgment","rationale":"Finite window after lag; no lifetime policy permanence or benefits after year13. Public/state baseline adoption and reversal may shorten this window.","sourceIds":[]},{"name":"p","value":0.2,"unit":"incremental coalition-enabled policy probability","basis":"judgment","rationale":"Twenty percent extra chance of a material package within five years because of the wider coalition's added effort, not probability that any state ever changes a tax. Current political opposition and small central staffing justify wide uncertainty.","sourceIds":[]},{"name":"a","value":0.05,"unit":"USAPA contribution within additional coalition effect","basis":"judgment","rationale":"Five percent reserves most credit for state/local organizations, elected officials, voters and fiscal pressures. National coordination, convening and communications provide a plausible but unmeasured enabling role.","sourceIds":["usapa-institute","usapa-state-training","usapa-podcast"]},{"name":"b","value":0.5,"unit":"marginal support additionality","basis":"judgment","rationale":"Half of incremental donor support creates otherwise absent capacity; the balance substitutes conference income, other donors, reserves or public/academic support. No restricted tax-only pathway assumed.","sourceIds":["usapa-irs24","usapa-budget-plan"]},{"name":"g","value":1,"unit":"USA resident share of modeled health","basis":"judgment","rationale":"N is explicitly defined as residents of 50 states plus DC covered by state policy. Thus all modeled outcomes qualify; foreign delegates and territories have no credited health. This does not assert all recipient spending is domestic.","sourceIds":[]},{"name":"h","value":0,"unit":"other net health harm over five-year cohort, before b","basis":"judgment","rationale":"No other portfolio health credited centrally. Financial hardship, stigma, unsafe substitution or abrupt unassisted withdrawal could create harm; central zero is a judgment and not a proven lower bound.","sourceIds":[]},{"name":"discount","value":0.03,"unit":"annual outcome discount rate","basis":"judgment","rationale":"Event-year discount; q already discounts life-years after that event.","sourceIds":[]},{"name":"historicalFullExpenses","value":[200361,26948,208012],"unit":"USD for FY2022,2023,2024","basis":"observed","rationale":"Accrual recipient totals; no additional direct event/rental/gaming/merchandise expense reported netted from revenue. Conference-cycle fluctuations and new CEO make their mean a poor current-cost proxy.","sourceIds":["usapa-irs22","usapa-irs23","usapa-irs24"]}],"scenarios":[{"id":"central","label":"Subjective expected value: one medium-state-equivalent opportunity","costUSD":1750000,"allPopulationQalys":4.010509219039689,"editionQalys":4.010509219039689,"assumptions":"Parameters {\"C\":350000,\"Y\":5,\"N\":5000000,\"d\":13.7,\"x\":0.05,\"e\":0.4,\"k\":0.75,\"q\":10,\"L\":3,\"T\":10,\"p\":0.2,\"a\":0.05,\"b\":0.5,\"g\":1,\"h\":0}; discounted years A=7.80634397866606."},{"id":"favorable","label":"Broader reach, effective policy and strong marginal role","costUSD":1250000,"allPopulationQalys":685.9560681318014,"editionQalys":685.9560681318014,"assumptions":"Parameters {\"C\":250000,\"Y\":5,\"N\":10000000,\"d\":13.7,\"x\":0.1,\"e\":1,\"k\":0.9,\"q\":15,\"L\":1,\"T\":15,\"p\":0.4,\"a\":0.1,\"b\":0.8,\"g\":1,\"h\":0}; discounted years A=11.590228239588424."},{"id":"poor","label":"Small short-lived policy with little donor leverage","costUSD":3500000,"allPopulationQalys":0.000030085015078863834,"editionQalys":0.000030085015078863834,"assumptions":"Parameters {\"C\":700000,\"Y\":5,\"N\":1000000,\"d\":13.7,\"x\":0.02,\"e\":0.1,\"k\":0.3,\"q\":3,\"L\":5,\"T\":3,\"p\":0.05,\"a\":0.01,\"b\":0.1,\"g\":1,\"h\":0}; discounted years A=2.439985002340943."},{"id":"short-duration","label":"Only three years of policy benefit","costUSD":1750000,"allPopulationQalys":1.329883020715277,"editionQalys":1.329883020715277,"assumptions":"Parameters {\"C\":350000,\"Y\":5,\"N\":5000000,\"d\":13.7,\"x\":0.05,\"e\":0.4,\"k\":0.75,\"q\":10,\"L\":3,\"T\":3,\"p\":0.2,\"a\":0.05,\"b\":0.5,\"g\":1,\"h\":0}; discounted years A=2.588580088983507."},{"id":"low-survival","label":"Only three QALYs per averted death","costUSD":1750000,"allPopulationQalys":1.203152765711907,"editionQalys":1.203152765711907,"assumptions":"Parameters {\"C\":350000,\"Y\":5,\"N\":5000000,\"d\":13.7,\"x\":0.05,\"e\":0.4,\"k\":0.75,\"q\":3,\"L\":3,\"T\":10,\"p\":0.2,\"a\":0.05,\"b\":0.5,\"g\":1,\"h\":0}; discounted years A=7.80634397866606."},{"id":"high-cost","label":"Current recipient scale twice central plan","costUSD":3500000,"allPopulationQalys":4.010509219039689,"editionQalys":4.010509219039689,"assumptions":"Parameters {\"C\":700000,\"Y\":5,\"N\":5000000,\"d\":13.7,\"x\":0.05,\"e\":0.4,\"k\":0.75,\"q\":10,\"L\":3,\"T\":10,\"p\":0.2,\"a\":0.05,\"b\":0.5,\"g\":1,\"h\":0}; discounted years A=7.80634397866606."},{"id":"no-policy","label":"No additional policy effect","costUSD":1750000,"allPopulationQalys":0,"editionQalys":0,"assumptions":"Parameters {\"C\":350000,\"Y\":5,\"N\":5000000,\"d\":13.7,\"x\":0.05,\"e\":0.4,\"k\":0.75,\"q\":10,\"L\":3,\"T\":10,\"p\":0,\"a\":0.05,\"b\":0.5,\"g\":1,\"h\":0}; discounted years A=7.80634397866606."},{"id":"no-health-response","label":"Tax changes no induced-disease mortality","costUSD":1750000,"allPopulationQalys":0,"editionQalys":0,"assumptions":"Parameters {\"C\":350000,\"Y\":5,\"N\":5000000,\"d\":13.7,\"x\":0.05,\"e\":0,\"k\":0.75,\"q\":10,\"L\":3,\"T\":10,\"p\":0.2,\"a\":0.05,\"b\":0.5,\"g\":1,\"h\":0}; discounted years A=7.80634397866606."},{"id":"adverse","label":"No policy benefit and one other QALY net harm","costUSD":1750000,"allPopulationQalys":-0.5,"editionQalys":-0.5,"assumptions":"Parameters {\"C\":350000,\"Y\":5,\"N\":5000000,\"d\":13.7,\"x\":0.05,\"e\":0.4,\"k\":0.75,\"q\":10,\"L\":3,\"T\":10,\"p\":0,\"a\":0.05,\"b\":0.5,\"g\":1,\"h\":1}; discounted years A=7.80634397866606."},{"id":"other-harm","label":"Five other QALYs of net harm","costUSD":1750000,"allPopulationQalys":1.5105092190396894,"editionQalys":1.5105092190396894,"assumptions":"Parameters {\"C\":350000,\"Y\":5,\"N\":5000000,\"d\":13.7,\"x\":0.05,\"e\":0.4,\"k\":0.75,\"q\":10,\"L\":3,\"T\":10,\"p\":0.2,\"a\":0.05,\"b\":0.5,\"g\":1,\"h\":5}; discounted years A=7.80634397866606."}],"sensitivity":["At other central assumptions, p*a must exceed 0.0436354 to beat $1 million per 10 QALYs, or 0.4363536 to beat $100,000. Central p*a is .01.","Equivalently, effective incremental coverage N*p*a must exceed about 218,177 residents for $1 million per 10 QALYs, or 2,181,768 for $100,000, before funding additionality. Central is 50,000 residents.","Other net health harm above 8.0210184 QALYs over the five-year cohort erases the central benefit before funding additionality. Such harm is not attenuated by p*a.","Doubling current cost doubles price; q=3 instead of10 makes it 3.33 times worse. Three-year rather than ten-year benefit duration is calculated separately.","Zero additional policy chance or zero disease-mortality response produces no favorable price. Clinical e and policy p/a are separate uncertainties; adopting a policy does not guarantee fewer deaths.","The national crude d=13.7 is not an age-adjusted rate. Actual target-state disease rates, population trends and mortality displacement could materially change health yield."],"missingInputs":["Current unrestricted operating budget, post-CEO compensation and grants, conference-cycle accruals, cash commitments and next-dollar workplan.","Specific target policy package, state resident population, exact all-beverage tax/pass-through change and plausible baseline enactment/implementation date.","Independent evidence of USAPA's added influence relative to local alliances, voters, fiscal pressure and other advocates.","Transferable heavy-drinker mortality response, age/comorbidity-specific remaining healthy survival, duration of effect, cross-border/substance substitution and harmful financial tradeoffs."]},"sources":[{"id":"usapa-irs24","title":"FY2024 Form 990, original IRS e-file","publisher":"US Alcohol Policy Alliance / IRS","url":"https://projects.propublica.org/nonprofits/full_text/202512589349301026/IRS990","published":null,"retrieved":"2026-09-13"},{"id":"usapa-irs23","title":"FY2023 Form 990, original IRS e-file","publisher":"US Alcohol Policy Alliance / IRS","url":"https://projects.propublica.org/nonprofits/full_text/202402889349302035/IRS990","published":null,"retrieved":"2026-09-13"},{"id":"usapa-irs22","title":"FY2022 Form 990, original IRS e-file","publisher":"US Alcohol Policy Alliance / IRS","url":"https://projects.propublica.org/nonprofits/full_text/202333199349304513/IRS990","published":null,"retrieved":"2026-09-13"},{"id":"usapa-home","title":"Current mission and policy portfolio","publisher":"US Alcohol Policy Alliance","url":"https://www.alcoholpolicy.org/","published":null,"retrieved":"2026-09-13"},{"id":"usapa-budget-plan","title":"Executive director recruitment, salary and operating-budget plan","publisher":"US Alcohol Policy Alliance","url":"https://www.alcoholpolicy.org/latest/usapa-executive-director","published":"2024-07-15","retrieved":"2026-09-13"},{"id":"usapa-ceo","title":"Appointment of Mike Marshall as CEO","publisher":"US Alcohol Policy Alliance","url":"https://www.alcoholpolicy.org/latest/usapa-taps-veteran-political-strategist-as-ceo","published":"2025-01-31","retrieved":"2026-09-13"},{"id":"usapa-institute","title":"Advocates Institute 2026 and planned national strategy","publisher":"US Alcohol Policy Alliance","url":"https://www.alcoholpolicyconference.org/advocate-institute","published":null,"retrieved":"2026-09-13"},{"id":"usapa-podcast","title":"The Shift: current state alcohol-tax discussion","publisher":"US Alcohol Policy Alliance","url":"https://www.alcoholpolicy.org/podcasts","published":null,"retrieved":"2026-09-13"},{"id":"usapa-cdc","title":"Alcohol Use: 2024 national mortality data","publisher":"CDC National Center for Health Statistics","url":"https://www.cdc.gov/nchs/fastats/alcohol.htm","published":null,"retrieved":"2026-09-13"},{"id":"usapa-ny-study","title":"Effects of alcohol taxes on alcohol-related disease mortality in New York, 1969–2006","publisher":"Delcher, Maldonado-Molina and Wagenaar / Addictive Behaviors","url":"https://pubmed.ncbi.nlm.nih.gov/22436591/","published":"2012-03-01","retrieved":"2026-09-13"},{"id":"usapa-illinois-reanalysis","title":"Do State Excise Taxes Reduce Alcohol-Related Fatal Motor Vehicle Crashes?","publisher":"McClelland and colleagues / Economic Inquiry","url":"https://onlinelibrary.wiley.com/doi/10.1111/ecin.12811","published":"2019-06-10","retrieved":"2026-09-13"},{"id":"usapa-maryland-study","title":"Maryland 2011 alcohol sales tax and beverage sales","publisher":"Esser, Waters, Smart and Jernigan / American Journal of Drug and Alcohol Abuse","url":"https://stacks.cdc.gov/view/cdc/77031/cdc_77031_DS1.pdf","published":"2016-04-11","retrieved":"2026-09-13"},{"id":"usapa-state-training","title":"Building Statewide Alliances to Reduce Alcohol-Related Harms","publisher":"Southeast Prevention Technology Transfer Center","url":"https://pttcnetwork.org/products-and-resources/page/3/?_keywords=alcohol-misuse-use","published":"2021-11-18","retrieved":"2026-09-13"}]}